Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,808.65 / $3,924.77 / $5,627.36	Facility		$1,808.65	$3,924.77	$5,627.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $1,827.54 / $4,401.00	Professional		$1,808.65	$1,827.54	$4,401.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,953.33 / $3,158.79 / $5,389.78	Facility		$1,953.33	$3,158.79	$5,389.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $1,808.65 / $3,049.38	Professional		$1,808.65	$1,808.65	$3,049.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,808.65 / $1,808.65 / $3,074.71	Facility		$1,808.65	$1,808.65	$3,074.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $1,808.65 / $2,441.67	Professional		$1,808.65	$1,808.65	$2,441.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,706.27 / $1,706.27 / $1,808.65	Facility		$1,706.27	$1,706.27	$1,808.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $1,808.65 / $2,819.46	Professional		$1,808.65	$1,808.65	$2,819.46
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,706.27 / $1,706.27 / $1,808.65	Facility		$1,706.27	$1,706.27	$1,808.65
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $1,808.65 / $2,819.46	Professional		$1,808.65	$1,808.65	$2,819.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,990.38 / $2,265.01 / $2,623.68	Professional		$1,990.38	$2,265.01	$2,623.68
United Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $1,808.65 / $2,170.38	Professional		$1,808.65	$1,808.65	$2,170.38